Scand J Trauma Resus
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Scand J Trauma Resus · Mar 2019
LetterResponse to: Best practice advice on pre-hospital emergency anaesthesia & advanced airway management.
The European HEMS and Air ambulance Committee's Medical working group recently published Best Practice advice on pre-hospital emergency anaesthesia and advanced airway management. We believe that this initiative is important. ⋯ We argue that pre-hospital emergency anaesthesia should be delivered with a competence level approximating in-hospital standard. In our experience, our patients benefit from pre-hospital emergency anaesthesia delivered by consultants with regular in-hospital rotations and a sound clinical governance system.
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Scand J Trauma Resus · Mar 2019
Female risk-adjusted survival advantage after injuries caused by falls, traffic or assault: a nationwide 11-year study.
A female survival advantage after injury has been observed, and animal models of trauma have suggested either hormonal or genetic mechanisms as component causes. Our aim was to compare age and risk-adjusted sex-related mortality in hospital for the three most common mechanisms of injury in relation to hormonal effects as seen by age. ⋯ In this 11-year population-based study we found no support for an oestrogen-related mechanism to explain the survival advantage for females compared to males following hospitalisation for injury.
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Scand J Trauma Resus · Mar 2019
Multicenter Study Observational StudyPneumonia in severely injured patients with thoracic trauma: results of a retrospective observational multi-centre study.
While the incidence and aspects of pneumonia in ICU patients has been extensively discussed in the literature, studies on the occurrence of pneumonia in severely injured patients are rare. The aim of the present study is to elucidate factors associated with the occurrence of pneumonia in severely injured patients with thoracic trauma. ⋯ Level II - Retrospective medical record review.
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Scand J Trauma Resus · Mar 2019
Observational StudyEmergency department non-invasive cardiac output study (EDNICO): a feasibility and repeatability study.
There is little published data investigating non-invasive cardiac output monitoring in the emergency department (ED). We assessed six non-invasive fluid responsiveness monitoring methods which measure cardiac output directly or indirectly for their feasibility and repeatability of measurements in the ED: (1) left ventricular outflow tract echocardiography derived velocity time integral, (2) common carotid artery blood flow, (3) suprasternal aortic Doppler, (4) bioreactance, (5) plethysmography with digital vascular unloading method, and (6) inferior vena cava collapsibility index. ⋯ Our study shows that non-invasive fluid responsiveness monitoring in the emergency department may be feasible with selected methods. Higher repeatability of measurements were observed in non-ultrasound methods. These findings have implications for further studies specifically assessing the accuracy of such non-invasive cardiac output methods and their effect on patient outcome in the ED in fluid depleted states such as sepsis.
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Scand J Trauma Resus · Mar 2019
The effect of hemorrhagic shock and intraosseous adrenaline injection on the delivery of a subsequently administered drug - an experimental study.
Intraosseous (IO) access is a recommended method when venous access cannot be rapidly established in an emergency. Experimental data suggest that major hemorrhage and catecholamine administration both reduce bone marrow blood flow. We studied the uptake of gentamicin as a tracer substance administered IO following adrenaline administration in hemorrhagic shock and in cardiac arrest. ⋯ No impairment of drug uptake with IO administration after recent IO adrenaline exposure was demonstrable in this shock model.